Uninsured? Here's how you still can get health care

If you don't have insurance, getting health care is more difficult these days — but not impossible.

Patients typically line up hours before the doors open at any of the free medical clinics run by Shepherd's Hope. Last year, more than 3,300 people were turned away because the group's volunteer doctors and nurses can treat only a limited number of patients on any given day.

"The system is burdened," said Cindi Kopelman, president of the Orlando nonprofit. "It's not easy to get in right away; some locations are busier than others. Some people will try to come back; some people will end up in the [emergency room], and some will just do nothing. A lot of people go without medical care for a long, long time."

A variety of state and private groups offer low-cost or no-cost health services in Orange and neighboring counties. Most clinics focus on primary care, or the type of complaints seen by a family doctor: earaches and urinary-tract infections. Sore throats and stomach viruses. Even diabetes and kidney stones.

Each organization is different. Many groups charge patients low fees based on their incomes. Others have no restrictions and charge nothing.

Florida Hospital runs a thrice-weekly Community After-Hours Clinic inside a small building near its main hospital in Orlando. There is no charge, but care is limited to the first 25 to 30 people each day.

Louis Federick, 52, was making his second visit to the clinic on a recent evening. He learned about it after seeking help at the hospital's emergency room. The Pine Hills man doesn't have health insurance — or any interest in going back to the ER.

"I'd rather come here," said Federick, who recently lost his job in a catering business. "You don't have the wait, and the doctors are nicer."

He got treatment for shingles, a painful rash triggered by the same virus that causes chickenpox, and then a flulike illness he probably picked up from his grandchildren.

Federick is lucky. His diagnosis and treatment were straightforward. Difficulties arise for similar patients with chronic or life-threatening conditions.

Josephine Mercado, who runs the nonprofit Hispanic Health Initiatives, remembers a recent breast-cancer patient granted emergency Medicaid coverage through the state. It lasts 45 days. When her Medicaid ran out, so did her chemotherapy.

"She had to scramble around for weeks and weeks before she could find anyone who would take her," Mercado said. "That's terrible, and it's happening all the time."

Dental services, mental-health treatment, even eye exams and routine screenings such as colonoscopies are scarce for the poor or uninsured. County health departments, a longtime source of care for the vulnerable, are straining under greater demand.

The Orange County Health Department saw a 15 percent increase in its uninsured clients, who rose from 5,524 in 2007 to about 6,500 in 2008. The lack of insurance will cause many to postpone treatment and create more problems down the road, said Dr. Kevin Sherin, department director.

"People who don't have insurance are always going to think, 'What am I going to have to pay to see a doctor?'" he said. "By the time they are seen, they're going to end up sicker, with more-intensive costs."